Night Nurse: Going Mental

In order to commemorate UK Black History Month, I’m going to spend the next few blog posts talking about ethnicity and blackness. If you don’t wanna read about it then.. um… see you in November I guess?

As you may or may not know, I tend to type these posts in advance. This one, however, is written the night before and is based on the talk I did on behalf of my student union on Black and Minority Ethnics and Mental Health. I spoke as someone who has experienced it, and as a layperson who is passionate about mental health advocacy, but I think I should take a nursing spin on it as well because the statistics that have come out in the past year have been … damning. Especially when it comes to BMEs.

Black men in Britain are 17 times more likely to be diagnosed with a serious mental illness than white men.

17 times.

In that same Guardian article, 70% of a certain borough’s residents in secure psychiatric residences are African or Caribbean.

This… this blows my mind. I don’t subscribe to the prevalent mentality in our community that mental health is a white people’s problem not something we suffer from, but these statistics are disproportionate to the percentage of BMEs in the country. Why? How?

A fascinating documentary on BBC3 has a healthcare professional making the assertion that because black people are seen as “aggressive” (black women being “angry”, black men being “monsters”), our diagnoses are going to be more severe. The immediate reaction of some healthcare professionals is one of “this person is dangerous, they need to be sectioned.”

I hear this and I understand this point, but I feel like a more nuanced answer is needed.

Mental health services are stretched to the limit right now. There are more people requiring the services than there are available. 1 in 4 people in the UK will experience some sort of mental health problem annually, and the facilities aren’t thre for people who need them. Living in London especially feels like a lottery where if you’re in a borough that has all the facilities available for you, then great, but if you don’t then bully for you. More affluent boroughs can afford to pour money into services that provide support for their residents, while lower income areas… well… don’t. This means that people can be turned away on the flimsy basis of “not being ill enough”, and are ignored until it’s too late . Often the only other alternative is to shell out exorbitant therapy fees, which if you’re from a lower income area you probably wouldn’t be able to do (going on from the assumption that you yourself are lower income).

On the subject of lower income backgrounds, poverty can play a huge part in mental health. Money may not buy happiness but it puts a roof over your head, clothes on your back and food on your table. It puts your kids through school and gets you to work. It opens doors and provides options. If you don’t have many options, you end up picking the one with the most short-term profit… even if it means joining a gang. That’s why so many gang members suffer from PTSD, depression, anxiety and survivor’s guilt.

There’s also a big problem with education. For one thing, I don’t think people realise how early problems can develop. Children can develop a theory of mind pretty early, and form identities, relationships and opinions at a young age. And yet an alarming amount of adults are unaware when their child needs support… or if they are aware, they think that the basics are sufficient. “She’s sad? Throw a toy at her. He’s angry? Put him on the naughty stool.” If root causes aren’t identified and rectified early in life then how can anyone expect a child to grow into a well adjusted adult? This can be seen by the ages at which some kids develop eating disorders: some research papers quote ages as young as 7.

On the subject of miseducation… man. I spoke to so many people with similar backgrounds to mine about mental illness and to hear what some of their parents have said is heartbreaking. It’s a belief that somehow goes deeper than ignorance, one borne from a combination of cultural heritage, religious fervour, perception and again, a dash of survivor’s guilt. “What have you got to be depressed about? You didn’t have to run away from your country, you didn’t have to work the fields. You are given all these gifts from God, why are you not grateful?” This mindset is toxic. When your family is your main support and that is the answer, what are you meant to do?

The thing of it is, while all of these things are definitely contributing factors to the current issues with mental health in the BME community, they cannot and do not account for all the increased likelihood in admissions. We healthcare providers do not have clean hands here, we cannot point the blame at backwards cultures and miseducation. We need to be trained, to be open to, and to be willing to recognise the specific struggles that black and minority ethnics face. And until we do that, those statistics will never change.

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